Evaluation of emergency and disaster preparedness of Head Start and Child Care Centers in Puerto Rico, 2008

Although natural disasters and terrorist events have affected children, many disaster preparedness plans do not contemplate the needs of children <5 y/o, the most vulnerable group. The objective of this study was to evaluate the preparedness level and response capability of two types of preschool facilities: Head Start and Child Care Centers. A representative sample (n=132) was selected using a stratified sampling design (99.2% participation). Interviewers conducted a survey (>100 questions). The center's location was determined using GPS to assess risks of flooding, tsunamis, landslides, and liquefaction due to earthquakes. Proportions were compared using chi-square or Fisher's exact tests. Both types of centers had an acceptable level of preparedness, but do not know their real risks, thus over or underestimate their risks. Most had a routinely evaluated, available, and fairly complete written emergency plan, which children/personnel knew though routine drills. However, these plans do not include all the centers' real risks. Personnel mostly knew routine emergency procedures, and prepared parents/ children on evacuation procedures. Most exits but few emergency routes are labeled, and few have formally evaluated potential obstacles in them. Most have not identified shelters, and use personnel cars for evacuation. Few have formal arrangements with municipal/state emergency agencies. Most have enough supplies, hygiene products, and cleaning supplies for an emergency, but only some have construction equipment/materials, supply restocking plans, and water/food rationing procedures. Centers have smoke detectors and fire extinguishers, but rarely fire alarms and sprinklers. Centers must evaluate their particular risks, and improve their emergency plans accordingly.